Patellofemoral Pain (PFP) is anterior knee pain that is aggravated by activities such as jumping, landing and kicking, and is almost always alleviated with the cessation of the aggravating activity.
PFP is common, accounting for 11-17% of all knee pain presentations to general practice and it typically occurs in physically active people aged <40 years, (Crossley, et al. 2016)
It is a very debilitating condition in jumping athletes with previous research indicating that 1/3 of athletes presenting with the condition were unable to return to sport within 6 months (Malliaras, et al. 2015)
There are 4 key principles to ensure effective management:
1) PFP is a multifactorial condition requiring an individually tailored program.
2) Immediate pain relief should be a priority
3) Patient empowerment by emphasising active over passive interventions is important.
4) Good patient education and activity modification is essential.
(Barton, et al. 2015)
Education, orthotics, dry needling, and load management are essential features of PFP management while exercises to strengthen the gluteal and quadriceps musculature, manual therapy and taping possessed the strongest evidence. Hip and knee strengthening exercises combined are superior to knee exercises alone for the treatment of PFP in the short and long term (van der Heijden RA, et al. 2015).
Most people will have noticeable improvement in their pain and function within 6-12 weeks of starting a multi-modal approach, as described above, but those who are older and who have had a long history of pain will need to expect a longer recovery period.
Research shows that poor hip abductor strength was a risk factor to future PFP pain in novice runners (Ramskov D, et al. 2015). Enhance Physiotherapy’s skilled physiotherapists’ are able to thoroughly examine you for specific deficits that are causing your PFP and can implement a treatment program to get you feeling and performing better.
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